Pain in the lumbosacral spine is the most common of all pain complaint. It causes loss of work and is the single most common cause of disability in persons under 45 years of age. Such is described in various well-known references directed to acute low back problems and in particular articles addressing pain management. Traction-like methods are well known for pain relief. Although pelvic traction has been used to treat patients with low back pain for hundreds of years, most neurosurgeons and orthopedists have not been enthusiastic about it secondary to concerns over inconsistent results and cumbersome equipment. Simple traction has been known to be highly effective. However, few pain clinics ever include traction as part of their approach. Various authors have reported varying techniques which widen disc spaces, decompress the discs, unload the vertebrate, reduce disc protrusion, reduce muscle spasm, separate vertebrate, and lengthen and stabilize the spine.
As addressed by C. Norman Shealy et al in the Fifth Edition of Pain Management, a Practical Guide for Clinicians, St. Lucie Press 1998, C. Norman Shealy et al addresses concepts in back pain management that include decompression, reduction and stabilization. Four broad categories of low back pain syndrome are identified as acute muscular low back paid which is usually self-limiting, acute low back pain involving sciatic radiation, chronic low back pain which has recurring symptoms modified by therapy, and neoplastic low back pain syndrome which is recurring, but eventually becoming progressive, constant, and intractable. Each type of low back pain syndrome has common features which vary with the intensity of the syndrome. Typically they will include regional pain, impairment and mechanical dysfunction exacerbated by activities of daily living, and mood and behavioral changes. It is agreed generally that all need to be addressed for overall successful outcome.
Mechanical traction is the technique of applying a distracting force to produce either a realignment of a structural abnormality or to relief abnormal pressure on nociceptive receptor systems. When successful, the patient clinically reports symptomatic improvement of well-being and objective clinical verification of improved range of motion, reduction of muscle spasm, improvement in regional tenderness, and improved neuropathic signs. Various therapeutic traction devices are known in the art. By way of example, U.S. Pat. No. 4,995,378 to Dyer et al describes a therapeutic table for providing traction in a prone position to a patient's lumbar region. A pelvic belt is rigidly anchored to the lower body section of the table. The patient lies prone face down on the table top. With arms above the head, the patient holds onto hand grips. The lower body section of the table to which the pelvic belt is attached is then separated from an upper body section of the table for applying traction to the lumbar region of the spine. Such anchoring of the upper body by use of the arms and partial frictional force of the body on the bed can be painful for weak or elderly patients.
U.S. Pat. No. 4,432,356 to Sarrell et al discloses a therapeutic traction table for statically or intermittently applying a traction force to the body of a patient. As is typically found for therapeutic traction tables, a straight traction force along the axis of the spine is applied to the patient while lying in a horizontal position on the bed of the table. Further, various harnessing devices have been disclosed for securing the patient to a traction device such as described in U.S. Pat. No. 5,217,488 to Wu for a motor operated traction device and U.S. Pat. No. 5,094,228 to Reinert for an apparatus for treatment of the back.
Although various therapeutic traction devices are disclosed, none provide for directing distraction forces to preselected areas of the spine and, in particular, to the lumbar spine. There is a need in the art to provide a therapeutic traction device that is easy for a clinician to use, facilitates placing of the patient for treatment, and can direct distraction forces to specific vertebrate in the lumbar spine to produce decompression or unloading due to distraction in positioning of intervertebral discs and facet joints.